Bosentan and sildenafil: successful treatment in a sclerodermic patient with refractory ulcers

Reumatismo. 2013 May 27;65(2):79-81. doi: 10.4081/reumatismo.2013.79.

Abstract

Systemic sclerosis is an inflammatory disease of the connective tissue characterized by vasculopathy and accumulation of collagen and other components of the connective matrix, affecting the skin and internal organs. The appearance of skin ulcers as a result of vascular damage is very common in the history of the disease. Skin ulcers, painful and slow healing due to atrophy and local ischemia, get worse the quality of life of patients. Often, the use of conventional therapies (such as calcium channel blockers and prostanoids) does not cause the complete healing of the lesions. We report the case of a patient in whom therapeutic association between endothelin antagonist (bosentan) and phosphodiesterase-V inhibitor (sildenafil) resulted in complete healing of old ulcers both to upper and lower limbs and allowed the interruption of intravenous therapies.

Publication types

  • Case Reports

MeSH terms

  • Bosentan
  • Endothelin Receptor Antagonists*
  • Female
  • Humans
  • Middle Aged
  • Phosphodiesterase 5 Inhibitors / therapeutic use*
  • Piperazines / therapeutic use*
  • Purines / therapeutic use
  • Remission Induction
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / drug therapy*
  • Sildenafil Citrate
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / etiology
  • Sulfonamides / therapeutic use*
  • Sulfones / therapeutic use*

Substances

  • Endothelin Receptor Antagonists
  • Phosphodiesterase 5 Inhibitors
  • Piperazines
  • Purines
  • Sulfonamides
  • Sulfones
  • Sildenafil Citrate
  • Bosentan